WCPanelIQ
PanelQMEGranted

Jose Verduzco — ADJ14370402

JOSE LUIS VERDUZCO, Applicant vs. MENDOZA PAINTING AND PRESSURE WASHING, and BENCHMARK INSURANCE COMPANY, administered by BENCHMARK ADMINISTRATORS INCORPORATED, Defendants

ADJ number
ADJ14370402
Decision date
May 3, 2022
District office
Santa Rosa
WCJ
—
Claim administrator
Benchmark Administrators Incorporated (administering Benchmark Insurance Company)
Commissioners
DEIDRA E. LOWE, COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR, CRAIG SNELLINGS, COMMISSIONER

Injury / body parts: right knee, right ankle, right foot

LC §5701LC §5705LC §5906

Summary

Applicant Jose Luis Verduzco suffered an industrial injury on May 26, 2020 to his right knee, ankle, and foot while working as a journeyman painter, requiring surgery on his right talus fracture. The WCJ awarded temporary total disability from May 27, 2020 through September 8, 2021, and applicant sought reconsideration claiming QME Dr. Mays' reports supported TTD continuing beyond that date. The Board majority found that Dr. Mays' opinion—stating applicant was TTD 'through the date' of the September 8, 2021 evaluation and that 'pending examinations' remained for determining work status—did not constitute substantial evidence on whether applicant's condition was P&S or whether TTD continued. The majority granted reconsideration, rescinded the F&A, and remanded for development of the record by obtaining a supplemental report from Dr. Mays. Commissioner Snellings dissented, agreeing with the WCJ that applicant failed to meet his burden of proof for additional TTD.

Issues

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Holding

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Analysis

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Applicant takeaway

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Defense takeaway

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Provider takeaway

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